After completing over 75 hours in training in an 18 month period and passing a 270+ question exam and practicum, Michael was awarded Certification in Spinal Manipulative Therapy (Cert SMT) by the American Academy of Manipulative Therapy in December 2012.Most people don't realize that joint manipulation is a part of the scope of practice of physical therapists, however because of the broad range of specialties of the PT profession, manipulation is used routinely only by a very small percentage (likely < 5%) of PTs, and an even smaller percentage carry certification through a post-graduate professional training and certification program.However, manipulation is considered a shared technique between PTs, chiropractors, and osteopathic physicians.There are differences in philosophies of use between the professions and even some small variations in techniques."I've found that manipulation, when used in accordance with the best practice evidence available, serves as a useful adjunct to a multi-modal treatment. That is, cracking necks or backs works best when combined with exercise, stretching, good postural habits and other modalities in a comprehensive program to help the patient get well. Manipulation alone is not a magic, one-shot bullet." ~ Michael